The human body consists of a series of internal organs. Like the rest of the human body, internal organs are affected by disease, the inability to function properly, as well as other complications. In these instances, it may become important to investigate, or in the most extreme case, remove the problematic organ(s) or portions thereof. A doctor can investigate the state of a person's organs or tissue using endoscopy or laparoscopy. The term “endoscope” refers generally to a visualization tool—now typically a small digital camera—that may be inserted into a patient's body through an existing orifice or a small incision. Similar visualization devices have differing names depending upon their region of intended use. For example, a “laparoscope” is a visualization device that is intended for use in the patient's abdomen. Using an appropriate “scope” tissue that needs to be removed can be identified and excised using other surgical tools passed into the same area. Laparoscopy continues to become more popular as advancements are made in this field. If laparoscopy is an option for a patient's surgical procedure, then the benefits can be enormous compared to laparotomy. These advantages include reducing post-operative pain, shortening hospital stays, and reducing recovery times. Although laparoscopy is not always an option for surgery, these advantages have led to more surgical procedures that use laparoscopy or computer-aided laparoscopy.
In the case of laparoscopy and laparotomy, it is extremely important for the surgeon to have the clearest view possible. Of course, in the case of laparotomy this is less of a problem since the patient has a large incision that allows the surgeon to see into the patient's body using ambient light from the operating room and fixed lights shining onto the operation region. However, laparoscopic surgery is accomplished using only a few small incisions in the patient's body with all the structures having to be viewed through the small “scope.”
Although laparoscopic surgery is less invasive than laparotomy, one commonly cited drawback is a lack of visibility of the operating area as it relates to visualizing hidden critical structures and the limited tactile feedback or the lack thereof altogether in robotic surgery applications. In laparoscopic surgery, this lack of visibility and tactile feedback can potentially lead to injury of vital structures including the ureters, bladder, major vessels, nerves as well as any other structures or organs in the relevant region of surgery (this depends on location of surgery). It would appear, then, that increased visibility would reduce the risk of injury during laparoscopic surgery.
One of many procedures that benefit from the use of laparoscopic surgery is a hysterectomy. A hysterectomy is the procedure in which a patient's uterus is surgically removed. There are several types of hysterectomies that can be performed. For example, a radical hysterectomy is the complete removal of the uterus, cervix, upper vagina, and parametrium. This type of hysterectomy is commonly used for the treatment of cancer. A total hysterectomy is the complete removal of the uterus and cervix, with or without oophorectomy (removal of the ovaries). A subtotal hysterectomy is the removal of the uterus, leaving the cervix in situ.
A common device used in laparoscopic hysterectomy is a uterine manipulator. A uterine manipulator is used to delineate the proper plane of dissection for colpotomy at the cervicovaginal junction (which is equipped with a colpotomy cup). In the event of a radical hysterectomy or a procedure involving a patient having cancer, a sponge stick is the preferred tool due to the absence of a stem entering the uterus. While an intrauterine stem is helpful for retraction of the uterus, the risk of inadvertent uterine perforation transabdominally is increased, which can cause upstaging of the cancer due to cancer cells spilling into the abdomen. This must be avoided at all costs.
A hysterectomy is a procedure which is commonly performed using a laparoscopic or robotically assisted laparoscopic technique. Therefore, what is needed in this particular example is a device that increases the visibility of the location at which to cut and/or cauterize the tissue in order to remove the patient's uterus more safely and effectively. However, more generally, what is needed is a device that increases the visibility of the location within the body at which the surgical procedure is taking place. Oftentimes the objective is to cut or cauterize tissue, but the objective can include any number of procedures—such as drawing fluid, locating a structure, stapling tissue, or simply maneuvering an organ or other structure. The present invention achieves this objective, as well as others that are explained in the following description.